How is anaphylaxis handled in the hospital ?

Posted on: Thu, 08/03/2000 - 8:28pm
VeesDad's picture
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Joined: 08/04/2000 - 09:00

So we've been told to use the EpiPen if needed and call 911 or go to the closest hospital (thankfully haven't had to do this yet).

Since the epi-pen only lasts 10-15 minutes, I am curious to know what exactly do they do at the hospital to subdue the reaction and get everything back under control? How long do you have to stay there afterwards?

Posted on: Thu, 08/03/2000 - 9:15pm
PattyR's picture
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Joined: 04/12/2002 - 09:00

My son has never needed more than one dose of epi. The first one has done the trick. They just will make you wait for a couple of hours to make sure the reaction does not return and that there is no adverse reaction to the epi. We only ended up in the ER once and at the time I didn't know as much as I do now. My mistake was not calling our allergist so that he could direct the care. The first ER Dr. didn't administer the epi right away. She instead tried Zantac and then steroids. When another Dr. was called in for an opinion, he immediately order the epi right into a vein. That stopped the reaction and after about 3 hours, we were ready go. I assume if the reaction had continued they would have administered the epi again.

Posted on: Thu, 08/03/2000 - 10:31pm
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DMB
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Joined: 02/22/2001 - 09:00

My son had his anaphylactic reaction before we had the epi-pen. When we got to the ER the Dr. determined it was anaphylaxis and gave him a shot (we had given him benadryl before we left). We had to stick around the hospital for a couple hours for him to be monitored. My son was only 18 mos old at the time. The shot did make him very "jittery" and "shaky". He was still pretty wound up after we got home.

Posted on: Thu, 08/03/2000 - 11:47pm
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Joined: 07/30/1999 - 09:00

My daughter was 2 when she had her anaphylactic reaction. In my case, I had the Epi, but wasn't sure when to administer it. She ended up vomiting which reintroduced the pnut into her system, and she reacted all over again. When I got to the hospital, her face was 3x the size it normally is. After the doctor 'chewed' me out for not using the Epi, they finally treated her with a shot of Benadryl, a shot of Epi, and she had to drink some Prednisone. She immediately went to sleep, and we had to stay there for about 3 hours. The ER dr. told us we had to watch her carefully through the night for any re-reaction. Since it was already 3 in the morning, I insisted she stay there overnight, because I felt very nervous about taking her home. They wouldn't keep her, and I literally watched her like a hawk the whole night. Every time she sighed, or moved, I panicked! Luckily, she was fine. I think if the ER dr. is that concerned about a re-reaction, they should keep the child in the hospital for observation. I know as far as insurances go, that may not be possible, but each case should be evaluated. If she had stayed, I think I would have been stronger knowing help was right there if needed.

Posted on: Fri, 08/04/2000 - 7:19am
Anonymous's picture
Anonymous (not verified)

My son has had two anaphylactic reactions. The first time, he was administered the Epi-pen at the local medical centre, given Benadryl and then watched closely for an hour. The 2nd time, we administered the Epi-pen but did not know that you were supposed to go to the hospital immediately thereafter. Twenty minutes later, he started to "go" again. If I had had a 2nd Epi-pen at that time, I would have given him another shot. However, I didn't. We got him to the hospital where he was given the Epi-pen again, some Benadryl and we spent the whole night in intensive care (his reaction was all encompassing as far as the symptoms of anaphylactic shock) because a reaction can occur again up to 8 hours after the initial reaction. This was from merely touching a rice krispie square with pb in it to his lips - it did not enter his mouth, he did not take a bite out of it. When we left the hospital, we were given a prescription for Pediapred (kid's prednisone) for him to take for a week. Now, fortunately, we know what to do. His school has 2 Epi-pens with the instruction that they are to administer the 2nd one if he has a reaction, 20 minutes after the 1st one if an ambulance has not arrived. This was my experience with it and I would not wish it upon anyone, especially my dear child! Best wishes, and welcome!
------------------

Posted on: Sat, 08/05/2000 - 5:48pm
VeesDad's picture
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Joined: 08/04/2000 - 09:00

PattyR,
You mention that they injected the EPi into a vein .. I was just reading the insert that comes in the EpiPen package and it strictly warns against intra-vascular injection since there is possibility of causing cerebral haemmorhaege (sp?) .. Were you aware of this risk when the incident happened?

Posted on: Sun, 08/06/2000 - 4:05am
sandi's picture
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Joined: 06/01/1999 - 09:00

My 5yo Pa son has had 3 severe reactions. The first severe one began after biting into and then immediately spitting out PB. i gave him Benadryl immediately, within 15 minutes he had a rash on his face. I began to drive to the Dr office and he became lethargic and had audible wheezing---I had the epi pen in hand ready to give when we got to the Dr office. He was given the epi and more Benadryl and w/in approx a minute he made a turn around. He said Mom lets go !! We of course stayed another hour w/ orders to watch him close for rebound reaction. THe second reaction occured after biting into a cookie that had been siiting next to a pb cookie. His syptoms began with nausea , no rash, no wheezing, I had a gut feeling things were well on there way to a full blown reaction and administered Benadryl and we took off to The childrens hospital ER. when we got there he was still only complaining of nausea, and the Er staff wasn.t worried, even though I had warned them of how fast he reacted the last time. They told me to have a seat and it was then that Sawyer began w/ resp difficulty, I can't tell you how fast we were escorted to the trauma room an IV was placed and they gave him IV Benadryl, no epi. we stayed that visit approx 4 hours, w/ discharge orders to stay away from peanuts---NO DUH!!! The 3rd and hopefully last time he ate a sweet tart candy off the hands of my neice whohad had pb for lunch and he started W/ in 10 minutes w/ resp difficulty I administered the epi ,called 911 and had the fire dept and EMs at my house in 5 minutes. By the time they got there he was breathing fine but I had him transported to the hospital anyway and they observed him and sent him home after3hours, no steroids prescribed only orders to cont Benadrly every 4 hours for the next 24 hours and again to stay away from Peanuts--Like we weren't???? I have learned that this little guys reactions are becoming much quicker as expected and I don't hesitate to give him the epi and have EMS transport.

Posted on: Sun, 08/06/2000 - 11:35am
PattyR's picture
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Joined: 04/12/2002 - 09:00

VeesDad,
I believe what you say and have to assume that I may be mistaken. I need to look into it more and see if I can track down the truth but you have me wondering. Thanks for the info. When they gave him the epi it was in a syringe rather than the epipen auto injector. Could that be the difference?
[This message has been edited by PattyR (edited August 06, 2000).]

Posted on: Sun, 08/06/2000 - 12:49pm
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Joined: 06/28/2000 - 09:00

I had to administer the epi-pen to my daughter for the first time last month I took her directly to ER afterwards and they kept her over night to watch her. My ped. allergist told me that if and when I had to use epi to go directly to ER and if they try to tell you're free to go home, if it hasn't been 3 hours then tell them you're staying or go wait in the car. I really was releived that they kept her, I was scared to death.

Posted on: Sun, 08/06/2000 - 1:09pm
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Joined: 06/18/2000 - 09:00

Before I knew about my sons allergies and before having the Epipen he had a severe reaction to wheat in a cracker. (hives from head to toe,flushing head to toe, wheezing, coughing, excess mucus, swollen face and vomitted in ER.) When I got to the hospital..trying to remain calm... I told the nurse I thought he was reacting to a cracker I had given him. They took name, insurance info., and then had me take him to the back. The took his pulse and pulsox (sp?) and then left the room. A nurse come back in and said the Dr. ordered a shot. I think it was steroid but may have been adrenaline...He was already acting like he felt better right after the shot. I waited by myself with him for about 5 min. and then the respiratory nurse gave him a breathing treatment. He was acting much better and the wheezing had stopped. He wanted to nurse and after about 5 min. he vomited everywhere...Allergist later said it could've been the shot that caused upset stomach....The doctor came in and didn't seem too concerned about the vomit. He said he was doing fine and that his blood pressure was fine from the start. He was free to go but I was told to avoid crackers! DUH! Mind you, I was probably there for about 1 hour tops! My 5 1/2 month old son was still flushed some and covered in hives. Noone ever said anything about a second reaction. I even questioned whether he should stay or not. Everyone acted like it wasn't necessary so I trusted them. I know better now...stand your ground!!! Fortunately, he didn't have a second reaction.His hives faded after about 3 hours.
tkiaml

Posted on: Mon, 08/07/2000 - 10:45pm
tkiaml's picture
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Joined: 06/18/2000 - 09:00

Hi everyone! I brought this one back to the top because I was hoping to find out more about specific situations of how the hospital personnel handled your child's case. I know others have given some of this info. on other threads but wondered if others have had experiences in which it seems the hospital didn't really seem to recognize the importance of acting quickly and observing the patient for secondary reactions. Hope you don't mind that I brought it to the top. thanks! tkiaml

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